| The clinical picture depends upon underlying causes, | | | | failure. |
| like acute GN (allergic disorder of kidneys), sudden | | | | Initially, during the first week of the disease, the |
| acute rise in blood pressure (malignant hypertension), | | | | signs and symtoms are of the primary disease, i.e. |
| or it may be a case of acute infection of the kidneys | | | | acute GN, dehydration, etc., and the patient starts |
| (pyelonephritis), or an advanced case of dehydration | | | | passing less urine than normal. If the condition |
| (due to repeated vomiting, diarrhoea, etc.), or due to | | | | remains undetected, i.e. specific attention is not paid, |
| loss of blood as a result of sudden bleeding, or due | | | | or the patient does not report to his physician about |
| to marked hypotension, i.e. fall in blood pressure in a | | | | the low output of urine, the vital period for saving |
| case of heart attack, or acute kidney failure may | | | | the kidneys is wasted, and the volume of urine |
| manifest itself due to the use of toxic drugs, as | | | | passed daily goes ondecreasing till it becomes less |
| explained earlier. Hence, the signs and symptoms | | | | than 400 ml, when an acute kidney failure is said to |
| vary with the basic disease the patient is suffering | | | | have been initiated. Due to the retention of water, |
| from. | | | | swelling of the face and other parts of body may |
| Immediate treatment should be started whenever | | | | develop. The patient will have marked symptoms of |
| any of the above diseases/conditions occur, and a | | | | nausea/ vomiting, drowsiness and convulsions, and |
| close watch should be kept on the daily output of | | | | even death may occur. Both blood urea and serum |
| urine. A general awareness is required on the part of | | | | creatinine will be raised. |
| everyone that whenever a kidney patient starts | | | | Treatment |
| passing less urine, he/she should consider that the | | | | The patient should be treated in a hospital. Besides |
| function of the kidneys is markedly threatened, and | | | | urgent measures, the underlying cause of the ARF |
| therefore, it is advisable that the amount of urine | | | | should be simultaneously looked into. If blood |
| passed each day should be collected and measured. | | | | pressure is markedly elevated, it should be lowered |
| It may seem very simple, but since collection of | | | | with suitable drugs. If infection is the sole reason, it |
| 24-hour urine is somewhat cumbersome and | | | | needs to be treated on the lines of UTI, already |
| distasteful, people may not like to follow it. As a | | | | discussed. And, if there is some obstruction in the |
| result, excretion of urine goes on reducing day by | | | | urinary tract, say, as a result of an enlarged prostate, |
| day, till it becomes . around 400 ml, and at this | | | | etc., it should be immediately dealt with in the |
| volume of urine, kidney failure occurs. Even serum | | | | hospital, by a team of doctors, including both |
| creatinine or blood urea does not run parallel to the | | | | physicians and surgeons. In case of loss of fluids |
| initial damage the kidneys. Hence, it is vital to keep a | | | | blood, measures should be taken accordingly. If drugs |
| close watch on the volume of the daily output of | | | | are the causative factors, they ought to be stopped |
| urine, in the various circumstances mentioned above, | | | | immediately. |
| which are responsible for sudden kidney damage | | | | |